Factores dieteticos y metabolicos en HS

Journal Scan / Review · November 14, 2019

Dietary and Metabolic Factors in the Pathogenesis of Hidradenitis Suppurativa

International Journal of Dermatology

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• The authors analyzed 25 studies to investigate the role of diet and metabolic factors in hidradenitis suppurativa (HS). Patients with HS were found to be four times more likely to be obese. Weight-loss interventions demonstrated improvement; however, there were some cases of worsening HS after surgical intervention.

• Particular interventions with some supporting evidence included supplementation of vitamin D, zinc, and vitamin B12 and exclusion of dairy and yeast. Additionally, managing malnutrition associated with weight-loss interventions is important, particularly after bariatric surgery.

– Caroline K. Crabtree, MD

Abstract 

Hidradenitis suppurativa (HS) is a systemic recalcitrant inflammatory condition characterized by debilitating lesions with high morbidity. Its known association with obesity and smoking indicate correlation with other environmental factors, such as diet, suggesting a larger role for lifestyle modifications in disease treatment. This study seeks to assess the contribution of weight loss and dietary intake in HS management. A primary literature search was conducted using PubMed, Web of Science, and CINAHL in November 2018 to include association and intervention studies on the influence of diet and weight on HS. Twenty-five articles were included. Meta-analysis of nine case-control studies across Asia, Europe, and the United States showed that HS patients are four times more likely to be obese compared to the general population; random effects pooled odds ratio 4.022 (2.667-6.065), P < 0.001. Five articles assessed weight-loss interventions and revealed mixed findings. The remaining articles included three association studies on micronutrient levels, eight dietary intervention studies, and one article analyzing both micronutrient association and dietary intervention. Included articles in this systematic review reveal that low serum zinc and vitamin D levels are associated with increased lesion count in HS. Supplementation of zinc, vitamin D, vitamin B12, or exclusion of dairy or brewer's yeast can be effective in partial or complete lesion resolution. Reviewed data show that weight loss from bariatric surgery may lead to HS improvement but often results in more severe malnutrition that worsens or even leads to new onset HS post bariatric surgery. Future reporting is needed to conclusively determine the role of diet in HS.

International Journal of Dermatology

Dietary and Metabolic Factors in the Pathogenesis of Hidradenitis Suppurativa: A Systematic Review

Int. J. Dermatol 2019 Oct 25;[EPub Ahead of Print], F Choi, L Lehmer, C Ekelem, NA Mesinkovska 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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